Mp29-06 a New Surgical Technology With Femtosecond Lasers Towards No Thermal Injury in Endoscopic Surgery

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) III (MP29)1 May 2024MP29-06 A NEW SURGICAL TECHNOLOGY WITH FEMTOSECOND LASERS TOWARDS NO THERMAL INJURY IN ENDOSCOPIC SURGERY Yutaro Tanaka, Yudai Yoshimura, Shuzo Hamamoto, Rie Tajiri, Kazufumi Takano, Masashi Yoshimura, Atsushi Okada, Sawatari-cho Mizuho-ku, Kenjiro Kohri, Takahiro Yasui, Yusuke Mori, Hiroshi Yoshikawa, and Mihoko Maruyama Yutaro TanakaYutaro Tanaka , Yudai YoshimuraYudai Yoshimura , Shuzo HamamotoShuzo Hamamoto , Rie TajiriRie Tajiri , Kazufumi TakanoKazufumi Takano , Masashi YoshimuraMasashi Yoshimura , Atsushi OkadaAtsushi Okada , Sawatari-cho Mizuho-kuSawatari-cho Mizuho-ku , Kenjiro KohriKenjiro Kohri , Takahiro YasuiTakahiro Yasui , Yusuke MoriYusuke Mori , Hiroshi YoshikawaHiroshi Yoshikawa , and Mihoko MaruyamaMihoko Maruyama View All Author Informationhttps://doi.org/10.1097/01.JU.0001008680.67760.37.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In urological surgery, especially endoscopic lithotripsy, Holmium YAG lasers are commonly used. However, sever complications, such as ureteral stricture and ureteral injury, have increased because these lasers result in thermal injury due to photo-absorption by water. In addition, stone fragments scattered by strong shock waves obstruct operating field. In laser processing fields, it has been well known that near-infrared femtosecond lasers can achieve precise ablation of various materials (e.g., metals and organic materials) with much smaller thermal effects and less shock waves. This study aims to evaluate the lithotripsy characteristics of the femtosecond laser processing for establishment of novel endoscopic surgery. METHODS: Urinary stones (calcium oxalate, calcium phosphate, magnesium ammonium phosphate and uric acid) were collected from the patients. They were irradiated with femtosecond lasers (wavelength: 800 nm, pulse duration: ∼100 fs) and Holmium YAG (wavelength: 2100 nm, pulse duration: ∼20 µs) in ex vivo study (in air or water) (Figure 1A). After the laser irradiation, the stone cross-sections were examined using optical microscopy, scanning electron microscopy, and surface profilometry. RESULTS: Femtosecond lasers sharply cut urinary stones less retropulsion in both air and water regardless of stone composition (Figure 1A). In contrast, by Holmium YAG lasers, the stones were fragmented with strong shock waves and rapid increasing temperatures in water. Examination of the stone cross-sections revealed that femtosecond lasers produced smooth surfaces with micrometer-scale precision (Figure 1B, C), while Holmium YAG lasers produced rough surfaces due to thermal alteration. CONCLUSIONS: This study successfully demonstrated precise cutting of urinary stones without significant thermal effects and shock waves by femtosecond lasers. These lasers offer the potential for a new endoscopic surgery that can safely cut tissues while minimizing thermal damage. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e483 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yutaro Tanaka More articles by this author Yudai Yoshimura More articles by this author Shuzo Hamamoto More articles by this author Rie Tajiri More articles by this author Kazufumi Takano More articles by this author Masashi Yoshimura More articles by this author Atsushi Okada More articles by this author Sawatari-cho Mizuho-ku More articles by this author Kenjiro Kohri More articles by this author Takahiro Yasui More articles by this author Yusuke Mori More articles by this author Hiroshi Yoshikawa More articles by this author Mihoko Maruyama More articles by this author Expand All Advertisement PDF downloadLoading ...